Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $147.90 / $147.90 / $147.90	Facility		$147.90	$147.90	$147.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $120.06 / $144.41 / $147.90	Professional		$120.06	$144.41	$147.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $30.69 / $147.90 / $191.40	Facility		$30.69	$147.90	$191.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $147.90 / $147.90 / $147.90	Professional		$147.90	$147.90	$147.90
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $147.90 / $147.90 / $156.60	Professional		$147.90	$147.90	$156.60
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $144.41 / $8,702.00 / $13,785.00	Facility		$144.41	$8,702.00	$13,785.00
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $147.90 / $147.90 / $147.90	Professional		$147.90	$147.90	$147.90
United Facility/Professional Professional Modifier Low / Median / High Price $145.00 / $145.00 / $159.50	Professional		$145.00	$145.00	$159.50